cms_WV: 5590

In collaboration with The Seattle Times, Big Local News is providing full-text nursing home deficiencies from Centers for Medicare & Medicaid Services (CMS). These files contain the full narrative details of each nursing home deficiency cited regulators. The files include deficiencies from Standard Surveys (routine inspections) and from Complaint Surveys. Complete data begins January 2011 (although some earlier inspections do show up). Individual states are provides as CSV files. A very large (4.5GB) national file is also provided as a zipped archive. New data will be updated on a monthly basis. For additional documentation, please see the README.

Data source: Big Local News · About: big-local-datasette

This data as json, copyable

rowid	facility_name	facility_id	address	city	state	zip	inspection_date	deficiency_tag	scope_severity	complaint	standard	eventid	inspection_text	filedate
5590	HERITAGE CENTER	515060	101-13TH STREET	HUNTINGTON	WV	25701	2014-12-12	386	D	0	1	VNJW11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on medical record review and staff interview, the facility failed to ensure the physician took an active role in supervising the care for Resident #222. There was no evidence of an accurate evaluation and review of the resident's condition to make informed decisions about the continued appropriateness of the resident's current medical regimen. The physician's progress note for Resident #222, written on 11/10/14, did not accurately reflect the residents medication regimen. This was true for one (1) of three (3) residents reviewed for the care area of death during Stage 2 of the Quality Indicator Survey (QIS). Resident Identifer: #222. Facility Census: 154. Findings Include: a) Resident #222 Review of Resident #222's medical record revealed he was admitted to the facility on [DATE] with the following physician's orders, Aspirin 81 mg(milligrams) po (by mouth) daily for [MEDICAL CONDITION], [MEDICATION NAME] 100 mg po daily for hypertension, [MEDICATION NAME] 25 mg po daily for hypertension, [MEDICATION NAME] 10 mg po daily for hypertension, [MEDICATION NAME] 2 mg po daily for [MEDICAL CONDITION], [MEDICATION NAME] 40 mg po daily for [MEDICAL CONDITION], [MEDICATION NAME] 150 mg po daily for [MEDICAL CONDITION] reflux disease, donepezil 10 mg po at bedtime for dementia, [MEDICATION NAME] sodium 100 mg po twice a day for constipation. The medical record indicated Resident #222 was seen by his attending physician on 11/10/14. The physician progress notes [REDACTED]. Under the heading symptoms the following was noted (typed as written), Pt (patient) states his bp gets this way all his life. Never had dizziness or chest pains. 88/41 on [MEDICATION NAME], HCTZ ([MEDICATION NAME]), [MEDICATION NAME]. BS (blood sugar) all good. The pulse documented on the progress note was 46 beats per minute and the blood pressure documented was 108/63. Under the section titled assessment/plan the following was documented by the physician (typed as written), [MEDICAL CONDITION]- decrease (noted by a downward pointed arrow) [MEDICATION NAME]. D/C (discontinue) HCTZ . Although the physician's 11/10/14 progress note indicated the resident was receiving [MEDICATION NAME], review of resident's physician orders, since the time of admission, and review of the medication administration record (MAR), since the time of admission, revealed the resident was not ordered or receiving [MEDICATION NAME] for hypertension On 11/10/14, a hand written physician's order was entered into the medical record which contained the following (typed as written): . decrease (indicated by a downward pointing arrow) [MEDICATION NAME] XL 50 mg (milligrams) po (by mouth) daily d/c HCTZ. These orders were transcribed to the MAR and Resident #222 began receiving [MEDICATION NAME] (a beta-blocker used to treat hypertension) 50 mg daily for hypertension on 11/11/14 at 9:00 a.m. He received this medication in addition to his previously ordered hypertension medications of [MEDICATION NAME] (a beta blocker used to treat Hypertension in the same class a [MEDICATION NAME]) 100 mg po daily and [MEDICATION NAME] (an ace inhibitor used to treat hypertension and [MEDICAL CONDITION]) 10 mg po daily. An interview with the Director of Nursing (DON) at 8:25 a.m. on 12/08/14, revealed the nurse who noted the order for the [MEDICATION NAME] and added it to the MAR should have looked for the previous order of [MEDICATION NAME] to discontinue it. She stated this was a necessary step since the physician wrote to decrease the medication. She indicated when the nursing staff found there was no [MEDICATION NAME] ordered they should have called the physician and clarified the order. At 8:57 a.m. on 12/08/14, Resident #222's attending physician was interviewed. She confirmed she saw Resident #222 on 11/10/14 for [MEDICAL CONDITION] (low blood pressure blood pressure reading of 90 millimeters of mercury (mm Hg) or less systolic blood pressure (the top number in a blood pressure reading) or 60 mm Hg or less diastolic blood pressure (the bottom number) is generally considered low blood pressure). She stated she must have misread the medications and confused the [MEDICATION NAME] with [MEDICATION NAME]. She stated she did not mean to start him on another medication to treat hypertension when he was being seen for [MEDICAL CONDITION]. She stated she meant to decrease the [MEDICATION NAME] on that date but confused it with [MEDICATION NAME]. She confirmed it was a mistake and the resident should not have been started on the [MEDICATION NAME] on 11/10/14.	2018-09-01